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Fractures as identifiers
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PATHOLOGY 2012 ABSTRACT SUPPLEMENT
POST-MORTEM LONG QT ANALYSIS OF SUDDEN INFANT DEATH SYNDROME Joanna Glengarry1, Jon Skinner2, Paul Morrow1 1Department of Forensic Pathology, LabPlus, Auckland City Hospital, Auckland, and 2Greenlane Paediatric and Congenital Cardiac Services, Starship Childrens Hospital, Auckland, New Zealand; on behalf of the Cardiac Inherited Disease Group New Zealand It is hypothesised that some cases of sudden unexplained infant death can be attributed to the long QT syndrome. This has been explored by a prospective, population-based molecular autopsy study conducted by the Cardiac Inherited Diseases Group, a New Zealand national multidisciplinary group. Over a 26 month period (2006–2008) DNA was stored from all cases of sudden unexpected infant death at the time of autopsy. Those cases in which the cause of death was unascertained (‘sudden infant death syndrome’) underwent genetic testing to look for the long QT syndrome. Positive cases triggered cardiac and genetic evaluation of first-degree relatives. In this talk, the results of this will be presented and the conclusions, with implications for autopsy practice will be discussed. EXHUMATIONS: AN OVERVIEW OF THE EXCAVATION AND RECOVERY OF BURIED EVIDENCE Soren Blau Victorian Institute of Forensic Medicine, Southbank, and Department of Forensic Medicine, Monash University, Vic, Australia In theory anyone can search for and recover buried evidence. Over the past decades, however, the benefits of utilising systematic and controlled field recovery techniques (based on well-established archaeological principles) at a number of small and large scale scenes of crime have been recognised.1–3 This short presentation provides an overview of the theory and practice of professional excavation and recovery of various types of buried evidence. The presentation highlights the ways in which the level of information required to address questions about identification and cause and manner of death can be augmented when exhumations are undertaken using controlled excavation techniques. References 1. Cheetham PN, Hanson I. Excavation and recovery in forensic archaeological investigations. In: Blau S, Ubelaker DH, editors. Handbook of Forensic Anthropology and Archaeology. California: Left Coast Press, 2009; 141–9. 2. Hunter J, Cox M. Forensic Archaeology: Advances in Theory and Practice. London: Routledge, 2005. 3. Spennemann DHR, Franke B. Archaeological techniques for exhumations: A unique data source for crime scene investigations. Forensic Sci Int 1995; 74: 5–15.
Pathology (2013), 45(S1)
must be unambiguous and there must be several points of concurrence between the deceased and ante-mortem records. The aim of this study is to investigate the usefulness of ante-mortem fractures as identifiers when the traditional methods are not available. An overview of a number of cases admitted to the Western Australian State Mortuary, where the identification process is problematic, will be presented. The number of ante-mortem fractures present in a random sample of deceased and their uniqueness will be examined. A case study involving a combined pathology and anthropology examination will be used to illustrate the usefulness and acceptability, at the Coronial level, of ante-mortem fractures as identifiers. WHEN THINGS GO AWRY Noel Woodford Victorian Institute of Forensic Medicine, Southbank, Vic, Australia This presentation will provide a pathologist’s perspective on some of the challenges and pitfalls associated with use of radiological imaging in forensic pathology including diagnostic difficulties, artefacts, and technical issues. AUTOPSY FOLLOWING SUDDEN UNEXPECTED INFANT DEATH: WHAT CONSTITUTES A FULL AUTOPSY IN 2013? Duncan MacGregor Department of Anatomical Pathology, Royal Children’s Hospital, Melbourne, Australia Many attempts to define sudden infant death syndrome have included phrases such as ‘full autopsy’ and ‘ancillary investigations’ without specifying what constitutes full autopsy, or which of the thousands of potential ancillary studies are necessary and appropriate to reach a conclusion of SIDS or unascertained cause of death. Some recent publications1 have commented on the evidence base for common practices and commonly performed investigations, but there remains considerable variation between different centres. The presentation will cover the rationale and evidence base for several major ancillary investigations, and for some less technical components of the autopsy process that may enhance the quality of investigation of sudden unexpected death in infancy. Reference 1. Weber MA, Sebire NJ. Postmortem investigation of sudden unexpected death in infancy: current issues and autopsy protocol. Diagn Histopathol 2009; 15: 510–23.
ADVANCES IN THE GENETIC INVESTIGATION OF SIDS
Alanah Buck, Daniel Moss Department of Forensic Pathology, PathWest, QEII Medical Centre, Perth, WA, Australia
John Christodoulou Western Sydney Genetics Program, Children’s Hospital at Westmead, Sydney, and Disciplines of Paediatrics and Child Health & Genetic Medicine, University of Sydney, Sydney, NSW, Australia
Identification of the deceased is an important feature of any death investigation. Generally, the main types of identification confirmation that are acceptable to the Courts are visual, dental, DNA and fingerprints. On occasion, these traditional identifiers are not available due to the condition of the body or lack of ante-mortem records, and other forms of acceptable identification must be sought. To be acceptable as a form of positive identification the feature in question
With the recognition through epidemiological studies that the prone sleeping position is a major cause of SIDS, simple measures have led to a significant reduction in its incidence. However, SIDS is still a major cause of infant mortality in the Western world, and in most cases detailed post-mortem examination fails to shed light on a possible aetiology. It is being increasingly recognised that apparent SIDS may be the consequence of a primary underlying
FRACTURES AS IDENTIFIERS
Copyright © Royal College of pathologists of Australasia. Unauthorized reproduction of this article is prohibited.
PATHOLOGY 2012 ABSTRACT SUPPLEMENT
POST-MORTEM LONG QT ANALYSIS OF SUDDEN INFANT DEATH SYNDROME Joanna Glengarry1, Jon Skinner2, Paul Morrow1 1Department of Forensic Pathology, LabPlus, Auckland City Hospital, Auckland, and 2Greenlane Paediatric and Congenital Cardiac Services, Starship Childrens Hospital, Auckland, New Zealand; on behalf of the Cardiac Inherited Disease Group New Zealand It is hypothesised that some cases of sudden unexplained infant death can be attributed to the long QT syndrome. This has been explored by a prospective, population-based molecular autopsy study conducted by the Cardiac Inherited Diseases Group, a New Zealand national multidisciplinary group. Over a 26 month period (2006–2008) DNA was stored from all cases of sudden unexpected infant death at the time of autopsy. Those cases in which the cause of death was unascertained (‘sudden infant death syndrome’) underwent genetic testing to look for the long QT syndrome. Positive cases triggered cardiac and genetic evaluation of first-degree relatives. In this talk, the results of this will be presented and the conclusions, with implications for autopsy practice will be discussed. EXHUMATIONS: AN OVERVIEW OF THE EXCAVATION AND RECOVERY OF BURIED EVIDENCE Soren Blau Victorian Institute of Forensic Medicine, Southbank, and Department of Forensic Medicine, Monash University, Vic, Australia In theory anyone can search for and recover buried evidence. Over the past decades, however, the benefits of utilising systematic and controlled field recovery techniques (based on well-established archaeological principles) at a number of small and large scale scenes of crime have been recognised.1–3 This short presentation provides an overview of the theory and practice of professional excavation and recovery of various types of buried evidence. The presentation highlights the ways in which the level of information required to address questions about identification and cause and manner of death can be augmented when exhumations are undertaken using controlled excavation techniques. References 1. Cheetham PN, Hanson I. Excavation and recovery in forensic archaeological investigations. In: Blau S, Ubelaker DH, editors. Handbook of Forensic Anthropology and Archaeology. California: Left Coast Press, 2009; 141–9. 2. Hunter J, Cox M. Forensic Archaeology: Advances in Theory and Practice. London: Routledge, 2005. 3. Spennemann DHR, Franke B. Archaeological techniques for exhumations: A unique data source for crime scene investigations. Forensic Sci Int 1995; 74: 5–15.
Pathology (2013), 45(S1)
must be unambiguous and there must be several points of concurrence between the deceased and ante-mortem records. The aim of this study is to investigate the usefulness of ante-mortem fractures as identifiers when the traditional methods are not available. An overview of a number of cases admitted to the Western Australian State Mortuary, where the identification process is problematic, will be presented. The number of ante-mortem fractures present in a random sample of deceased and their uniqueness will be examined. A case study involving a combined pathology and anthropology examination will be used to illustrate the usefulness and acceptability, at the Coronial level, of ante-mortem fractures as identifiers. WHEN THINGS GO AWRY Noel Woodford Victorian Institute of Forensic Medicine, Southbank, Vic, Australia This presentation will provide a pathologist’s perspective on some of the challenges and pitfalls associated with use of radiological imaging in forensic pathology including diagnostic difficulties, artefacts, and technical issues. AUTOPSY FOLLOWING SUDDEN UNEXPECTED INFANT DEATH: WHAT CONSTITUTES A FULL AUTOPSY IN 2013? Duncan MacGregor Department of Anatomical Pathology, Royal Children’s Hospital, Melbourne, Australia Many attempts to define sudden infant death syndrome have included phrases such as ‘full autopsy’ and ‘ancillary investigations’ without specifying what constitutes full autopsy, or which of the thousands of potential ancillary studies are necessary and appropriate to reach a conclusion of SIDS or unascertained cause of death. Some recent publications1 have commented on the evidence base for common practices and commonly performed investigations, but there remains considerable variation between different centres. The presentation will cover the rationale and evidence base for several major ancillary investigations, and for some less technical components of the autopsy process that may enhance the quality of investigation of sudden unexpected death in infancy. Reference 1. Weber MA, Sebire NJ. Postmortem investigation of sudden unexpected death in infancy: current issues and autopsy protocol. Diagn Histopathol 2009; 15: 510–23.
ADVANCES IN THE GENETIC INVESTIGATION OF SIDS
Alanah Buck, Daniel Moss Department of Forensic Pathology, PathWest, QEII Medical Centre, Perth, WA, Australia
John Christodoulou Western Sydney Genetics Program, Children’s Hospital at Westmead, Sydney, and Disciplines of Paediatrics and Child Health & Genetic Medicine, University of Sydney, Sydney, NSW, Australia
Identification of the deceased is an important feature of any death investigation. Generally, the main types of identification confirmation that are acceptable to the Courts are visual, dental, DNA and fingerprints. On occasion, these traditional identifiers are not available due to the condition of the body or lack of ante-mortem records, and other forms of acceptable identification must be sought. To be acceptable as a form of positive identification the feature in question
With the recognition through epidemiological studies that the prone sleeping position is a major cause of SIDS, simple measures have led to a significant reduction in its incidence. However, SIDS is still a major cause of infant mortality in the Western world, and in most cases detailed post-mortem examination fails to shed light on a possible aetiology. It is being increasingly recognised that apparent SIDS may be the consequence of a primary underlying
FRACTURES AS IDENTIFIERS
Copyright © Royal College of pathologists of Australasia. Unauthorized reproduction of this article is prohibited.